Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

Adherence to Prescribed Acamprosate® in Alcohol Dependence and 1-Year Morbidities and Mortality: Utilizing a Data Linkage Methodology

Version 1 : Received: 30 March 2021 / Approved: 31 March 2021 / Online: 31 March 2021 (11:23:38 CEST)

A peer-reviewed article of this Preprint also exists.

Tolomeo, S.; Baldacchino, A. Adherence to Prescribed Acamprosate in Alcohol Dependence and 1-Year Morbidities and Mortality: Utilizing a Data Linkage Methodology. J. Clin. Med. 2021, 10, 2102. Tolomeo, S.; Baldacchino, A. Adherence to Prescribed Acamprosate in Alcohol Dependence and 1-Year Morbidities and Mortality: Utilizing a Data Linkage Methodology. J. Clin. Med. 2021, 10, 2102.

Journal reference: J. Clin. Med. 2021, 10, 2102
DOI: 10.3390/jcm10102102

Abstract

Objectives We tested the hypothesis that poor adherence is associated with a greater risk of alcohol-caused mortality and morbidities within the first year of discontinuing this medication. Materials and Methods Retrospective cohort study of 3319 individuals who received Acamprosate® in the East of Scotland in a 10-year period using a health informatics approach with record linkage of dispensing data, hospital utilization (SMR) and General Register Office of Scotland (GROS) data. Primary outcome was adherence between one to six months of initiating Acamprosate® medication. Secondary outcome was all cause morbidities and mortality. Results Of the total 3319 individuals identified, good adherence index of >80% was found in 59% of those prescribed Acamprosate® after three months and 6% after six months. There were significant linear trends of poorer adherence with increased risk of alcohol-caused mortality (HR1.2), medical morbidities especially neoplasm (HR 4.1|) and poisoning (HR 1.4) and psychiatric morbidities especially stress (HR 35.1), psychotic (HR 5.6) and neurotic disorders and directly alcohol induced conditions (7.4 HR) after adjustment for other factors within a one-year period of initiation of Acamprosate® treatment. Discussion and Conclusions Further exploratory studies using this digitalized approach should be encouraged in order to capture role of compliance to Acamprosate® and other types of medication that are known to reduce relapse into alcohol dependence and its direct relationship to mortality and morbidities in this population.

Keywords

adherence; alcohol; morbidities; mortality; data linkage

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